Provider Demographics
NPI:1689824690
Name:COORDINATED CARE PLANNING
Entity Type:Organization
Organization Name:COORDINATED CARE PLANNING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:GIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-373-3771
Mailing Address - Street 1:1401 E INVERNESS DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-1708
Mailing Address - Country:US
Mailing Address - Phone:907-373-3771
Mailing Address - Fax:907-373-3768
Practice Address - Street 1:1401 E INVERNESS DR
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-1708
Practice Address - Country:US
Practice Address - Phone:907-373-3771
Practice Address - Fax:907-373-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK425211251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCM74821Medicaid
AKCMG482Medicaid